Cardiology Department, Military Hospital in Marrakesh, Morocco.
Community Medicine and Public Health Department, Research Laboratory, Biosciences and Health, School of Medicine, Cadi Ayyad University/ Clinical Research Unit, Mohammed VI University Hospital, Marrakech, Morocco.
Biomed Res Int. 2020 Sep 14;2020:2587530. doi: 10.1155/2020/2587530. eCollection 2020.
An increase in left atrial (LA) size in patients with arterial hypertension (AHT) has long been known to be associated with worse cardiovascular morbidity and mortality contributes to various complications, including atrial arrhythmias, stroke, and heart failure. The aim of our study was to evaluate the impact of arterial hypertension (AHT) on the LA size and function. This cross-sectional investigation included one hundred patients with essential hypertension without valvular or structural heart disease and atrial fibrillation. All recruits had a transthoracic echocardiography. LA volumes were measured by area-length method in transthoracic echocardiography at different cardiac cycle times. The indices of LA function were calculated: the reservoir function (total emptying fraction, total emptying volume, and expansion index), the conduit function (passive emptying fraction and passive emptying volume), and the pump function (active emptying fraction and active emptying volume). For all statistical tests, a value ≤0.05 (represents the degree of significance) is considered statistically significant. In univariate analysis, LA was dilated in 9% of patients. The LA reservoir function and the pump function were increased, respectively, in 85% and 82% of patients. LA conduit function was impaired in 80% of patients. In bivariate analysis, the most powerful factors for this repercussion were diabetes (LA volume MAX dilated in nondiabetic patients ( = 0.037)), obesity (the reservoir function was impaired in obese patients ( = 0.015)), and antihypertensive drugs (the reservoir function was impaired in patients who take beta blockers ( = 0.023); the LA pump function was significantly impaired in patients treated with calcium antagonists ( = 0.012)). This study proved the impact of AHT on the LA size and function. Further investigations are necessary to evaluate the potential predictive value of LA remodeling in hypertensive patients like speckle tracking imaging.
长期以来,人们一直知道,动脉高血压(AHT)患者的左心房(LA)大小增加与心血管发病率和死亡率的恶化有关,并导致各种并发症,包括心房心律失常、中风和心力衰竭。我们的研究目的是评估动脉高血压(AHT)对 LA 大小和功能的影响。这项横断面研究包括 100 名无瓣膜或结构性心脏病和心房颤动的原发性高血压患者。所有患者均接受经胸超声心动图检查。LA 容积通过经胸超声心动图的面积-长度法在不同的心动周期时间进行测量。计算 LA 功能指数:储器功能(总排空分数、总排空量和扩张指数)、输送功能(被动排空分数和被动排空量)和泵功能(主动排空分数和主动排空量)。对于所有统计检验, 值≤0.05(表示显著性程度)被认为具有统计学意义。在单变量分析中,9%的患者 LA 扩张。分别有 85%和 82%的患者 LA 储器功能和泵功能增加。80%的患者 LA 输送功能受损。在双变量分析中,这种影响的最有力因素是糖尿病(非糖尿病患者的 LA 最大容积扩张( = 0.037))、肥胖(肥胖患者的储器功能受损( = 0.015))和抗高血压药物(服用β受体阻滞剂的患者储器功能受损( = 0.023);接受钙通道阻滞剂治疗的患者 LA 泵功能明显受损( = 0.012))。这项研究证明了 AHT 对 LA 大小和功能的影响。需要进一步的研究来评估 LA 重构在高血压患者中的潜在预测价值,如斑点追踪成像。